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Metagenomics of Toenail Onychomycosis in Three Victorian Regions of Australia. J Fungi (Basel) 2022; 8:jof8111198. [DOI: 10.3390/jof8111198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/01/2022] [Accepted: 11/04/2022] [Indexed: 11/16/2022] Open
Abstract
Onychomycosis is a fungal disease of the nail that is found worldwide and is difficult to diagnose accurately. This study used metagenomics to investigate the microbiology of 18 clinically diagnosed mycotic nails and two normal nails for fungi and bacteria using the ITS2 and 16S loci. Four mycotic nails were from Bass Coast, six from Melbourne Metropolitan and eight from Shepparton, Victoria, Australia. The mycotic nails were photographed and metagenomically analysed. The ITS2 sequences for T. rubrum and T. interdigitale/mentagrophytes averaged over 90% of hits in 14/18 nails. The high abundance of sequences of a single dermatophyte, compared to all other fungi in a single nail, made it the most likely infecting agents (MLIA). Trichophyton rubrum and T. interdigitale/mentagrophytes were found in Bass Coast and Shepparton while only T. interdigitale/mentagrophytes was found in Melbourne. Two nails with T. interdigitale/mentagrophytes mixed with high abundance non-dermatophyte moulds (NDMs) (Aspergillus versicolor, Acremonium sclerotigenum) were also observed. The two control nails contained chiefly Fusarium oxysporum and Malassezia slooffiae. For bacteria, Staphylococcus epidermidis was in every nail and was the most abundant, including the control nails, with an overall mean rate of 66.01%. Rothia koreensis, Corynebacterium tuberculostearicum, and Brevibacterium sediminis also featured.
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Watanabe S, Iozumi K, Abe M, Ito Y, Uesugi T, Onoduka T, Kato I, Kato F, Kodama K, Takahashi H, Takeda O, Tomizawa K, Tateishi Y, Fujii M, Mayama J, Muramoto F, Yasuda H, Yamanaka K, Oh-I T, Kasai H, Tsuboi R, Hattori N, Maruyama R, Omi T, Shimoyama H, Nakasu I, Watanabe-Okada E, Nishimoto S, Mochizuki T, Fukuzawa M, Seishima M, Sugiura K, Yamamoto O, Shindo M, Kiryu H, Kusuhara M, Takenaka M. Clinical effectiveness of efinaconazole 10% solution for treatment of onychomycosis with longitudinal spikes. J Dermatol 2021; 48:1474-1481. [PMID: 34212423 PMCID: PMC8518491 DOI: 10.1111/1346-8138.16035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/31/2021] [Indexed: 11/29/2022]
Abstract
Onychomycosis with longitudinal spikes in the nail plate has been reported to be refractory to oral drugs as with dermatophytoma. We evaluated the efficacy of 10% efinaconazole solution in the treatment of onychomycosis with longitudinal spikes. Of the 223 subjects who were enrolled in a previous study, a post‐hoc analysis of 82 subjects with longitudinal spikes was performed in this study. The opacity ratio of longitudinal spikes was decreased over time from 8.1 to 0.9 at the final assessment. In addition, the longitudinal spike disappearance rate increased early after the application to 81.7% at the final assessment. Therefore, 10% efinaconazole solution can be a first‐line drug for longitudinal spikes, which have been regarded as refractory to oral drugs.
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Affiliation(s)
- Shinichi Watanabe
- Department of Dermatology, Teikyo University School of Medicine, Tokyo, Japan
| | - Ken Iozumi
- Department of Dermatology, Tokyo Metropolitan Police Hospital, Tokyo, Japan
| | | | | | | | | | - Ichiro Kato
- Eniwa Station Dermatology Clinic, Eniwa, Japan
| | | | | | | | - Osamu Takeda
- Takeda Dermatological Skin Care Clinic, Sapporo, Japan
| | | | | | - Mizue Fujii
- Department of Dermatology, Asahikawa Medical University Hospital, Asahikawa, Japan
| | - Jun Mayama
- Chitose Dermatology and Plastic Surgery Clinic, Chitose,, Japan
| | | | | | | | | | - Hiroko Kasai
- Department of Dermatology, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Ryoji Tsuboi
- Department of Dermatology, Tokyo Medical University, Tokyo, Japan
| | | | | | - Tokuya Omi
- Queen's Square Medical Center, Yokohama, Japan
| | - Harunari Shimoyama
- Department of Dermatology, Teikyo University Mizonokuchi Hospital, Kawasaki, Japan
| | | | - Emiko Watanabe-Okada
- Department of Dermatology, Saiseikai Yokohama-shi Tobu Hospital, Yokohama, Japan.,Department of Dermatology, Saiseikai Kanagawa Hospital, Yokohama, Japan
| | - Shuhei Nishimoto
- Department of Dermatology, Kawasaki Municipal Hospital, Kawasaki, Japan
| | - Takashi Mochizuki
- Department of Dermatology, Kanazawa Medical University, Kanazawa, Japan
| | - Masao Fukuzawa
- Department of Dermatology, Ina Central Hospital, Ina, Japan
| | - Mariko Seishima
- Department of Dermatology, Gifu University Graduate School of Medicine, Gifu, Japan
| | | | - Osamu Yamamoto
- Division of Dermatology, Department of Medicine of Sensory and Motor Organs, Tottori University Faculty of Medicine, Yonago, Japan
| | - Masahisa Shindo
- Department of Dermatology, National Hospital Organization Hamada Medical Center, Hamada, Japan
| | | | | | - Motoi Takenaka
- Department of Dermatology, Nagasaki University Hospital, Nagasaki, Japan
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Mochizuki T, Tsuboi R, Iozumi K, Ishizaki S, Ushigami T, Ogawa Y, Kaneko T, Kawai M, Kitami Y, Kusuhara M, Kono T, Sato T, Sato T, Shimoyama H, Takenaka M, Tanabe H, Tsuji G, Tsunemi Y, Hata Y, Harada K, Fukuda T, Matsuda T, Maruyama R. Guidelines for the management of dermatomycosis (2019). J Dermatol 2020; 47:1343-1373. [DOI: 10.1111/1346-8138.15618] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 08/24/2020] [Indexed: 01/19/2023]
Affiliation(s)
| | - Ryoji Tsuboi
- Department of Dermatology Tokyo Medical University TokyoJapan
| | - Ken Iozumi
- Department of Dermatology Tokyo Metropolitan Police Hospital TokyoJapan
| | - Sumiko Ishizaki
- Department of Dermatology Tokyo Women’s Medical University Medical Center East TokyoJapan
| | | | - Yumi Ogawa
- Department of Dermatology Juntendo University TokyoJapan
| | - Takehiko Kaneko
- Graduate School of Human Ecology Wayo Women’s University IchikawaJapan
| | - Masaaki Kawai
- Department of Dermatology Juntendo University Koshigaya Hospital KoshigayaJapan
| | - Yuki Kitami
- Department of Dermatology Showa University TokyoJapan
| | | | - Takeshi Kono
- Department of Dermatology Nippon Medical School Chibahokusoh Hospital InzaiJapan
| | | | - Tomotaka Sato
- Department of Dermatology Teikyo University Medical Center IchiharaJapan
| | - Harunari Shimoyama
- Department of Dermatology Teikyo University Mizonokuchi Hospital KawasakiJapan
| | - Motoi Takenaka
- Department of Dermatology Nagasaki University NagasakiJapan
| | | | - Gaku Tsuji
- Department of Dermatology Kyushu UniversityGraduate School of Medical Sciences FukuokaJapan
| | - Yuichiro Tsunemi
- Department of Dermatology Saitama Medical University MoroyamaJapan
| | - Yasuki Hata
- Kanagawa Hata Dermatology Clinic YokohamaJapan
| | | | - Tomoo Fukuda
- Department of Dermatology Saitama Medical Center KawagoeJapan
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Onji M, Amano K, Matuki K, Kondou S, Hamada T, Furukawa S, Miyake T. Severe kyphosis as a risk factor of umbilical trichophytosis in elderly people. J Rural Med 2020; 15:92-97. [PMID: 32704334 PMCID: PMC7369409 DOI: 10.2185/jrm.2019-020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Accepted: 03/23/2020] [Indexed: 11/27/2022] Open
Abstract
Objective: To determine whether severe kyphosis is one of the risk factors
of umbilical trichophytosis in elderly people. Patients and Methods: Four cases with umbilical trichophytosis in the last 3
years and all 143 patients who visited to our clinic during from April 2018 to March 2019
were included in this study. The relationship between the condition of umbilical region
and kyphosis was investigated. As regards the levels of senile kyphosis, simple visual
classification of the kyphosis method was used (Level 0–4). Results: All four cases with umbilical trichophytosis were elderly women
aged ≥80 years, had severe kyphosis, skin overlaps, filthy umbilical region, and lumps of
dirt in the umbilical region and had nail tinea. Only two cases had umbilical
trichophytosis among 143 patients who visited our clinic during the 1 year study period,
with incidence is of 1.4%/year. About 65.7%, 60%, and 37.1% of 35 patients with kyphosis
with forward-bent posture had skin overlap, moist, and filthy umbilical regions,
respectively. However, these symptoms were not found in patients without severe
kyphosis. Conclusion: Severe kyphosis with forward-bent posture could be one of the
risk factors of umbilical trichophytosis in elderly people.
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Affiliation(s)
- Morikazu Onji
- Ehime University Graduate School of Medicine, Japan.,Department of Internal Medicine, Kumakogen Town Hospital, Japan.,Fujimine Clinic, Japan
| | | | - Katuyuki Matuki
- Department of Internal Medicine, Kumakogen Town Hospital, Japan
| | - Seiji Kondou
- Department of Internal Medicine, Kumakogen Town Hospital, Japan
| | - Tooru Hamada
- Department of Internal Medicine, Kumakogen Town Hospital, Japan
| | | | - Teruki Miyake
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Japan
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Tamura T, Asahara M, Yamamoto M, Yamaura M, Matsumura M, Goto K, Rezaei-Matehkolaei A, Mirhendi H, Makimura M, Makimura K. In vitro susceptibility of dermatomycoses agents to six antifungal drugs and evaluation by fractional inhibitory concentration index of combined effects of amorolfine and itraconazole in dermatophytes. Microbiol Immunol 2014; 58:1-8. [PMID: 24215461 DOI: 10.1111/1348-0421.12109] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 10/25/2013] [Accepted: 10/28/2013] [Indexed: 11/28/2022]
Abstract
To investigate the antifungal drug susceptibility of fungi responsible for dermatomycoses, minimum inhibition concentration (MIC) tests were performed in 44 strains of dermatophytes, including Trichophyton rubrum, Trichophyton mentagrophytes, Trichophyton verrucosum, Trichophyton tonsurans, Microsporum canis, Microsporum gypseum and Epidermophyton floccosum, with six antifungal drugs (amorolfine, terbinafine, butenafine, ketoconazole, itraconazole and bifonazole) by broth microdilution assay according to Clinical Laboratory Standard Institute protocols. Six possible dermatomycosis-causing non-dermatophytic fungi were also tested. The two major causes of tinea, T. rubrum and T. mentagrophytes, showed significantly different sensitivities to ketoconazole and bifonazole. Clinically derived dermatophytes were sensitive to the six antifungal drugs tested. However, non-dermatophytes, especially Fusarium spp., tended to be resistant to these antifungal drugs. In Trichophyton spp., the MICs of non-azole drugs had narrower distributions than those of azoles. To evaluate the effects of antifungal drug combinations, the fractional inhibitory concentration index was calculated for the combination of amorolfine and itraconazole as representative external and internal drugs for dermatophytes. It was found that this combination had synergistic or additive effects on most dermatophytes, and had no antagonistic effects. The variation in susceptibility of clinically derived fungal isolates indicates that identification of causative fungi is indispensable for appropriately choosing effective antifungal drugs in the early stages of infection. The results of combination assay suggest that multiple drugs with different antifungal mechanisms against growth of dermatophytes should be used to treat refractory dermatomycoses, especially onychomycosis.
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Affiliation(s)
- Takashi Tamura
- Department of Clinical Laboratory Science, Graduate School of Medical Technology; Eiken Chemical, 4-19-9 Taito, Taito-ku, Tokyo, 110-8408, Japan
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